Individual
RICHARD Q CALLAHAN
Active
Individual
RICHARD Q CALLAHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSPA, PA-C
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
055-0030786
VT
363AS0400X
Surgical Physician Assistant
055-0030786
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
055-0030786
LICENSE
VT
Enumeration date
10/24/2005
Last updated
11/12/2013
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